Del Mar Birth Center

I am very excited to bring you another Birth Center Project feature. To learn about my project, click here.


Stars align, people’s paths cross, and things happen…for a reason.

I was in search of my next birth center to feature. I had just attended the Improving Birth rally against the ban on breech birth where I saw various professionals from the birth world, but because of the craziness of the rally, I didn’t get the opportunity to talk to any of them. Not too long after the rally, I attended a discussion panel put on at Bini Birth. It was at this discussion panel that I was able to speak to Dr. Elliot Berlin—who is an incredible human being and knows a lot of people.

I was on Facebook a few days after speaking to Dr. Berlin when I noticed that he had posted something about Del Mar Birth Center. The words “birth center” alone caught my attention. I piggybacked on his post letting him, them, anyone who would answer know that I was interested in visiting, and guess what? It happened!

I really enjoyed spending time at Del Mar Birth Center. It was an extra special treat to have visited the birth center during a mom and baby support group. There were moms, there were babies, midwives, and other staff. I was in birth heaven (and I even felt a tiny bit of baby fever). Amidst all the chaos—because of the positively engaged people—there was harmony and peace in the space. The midwives were catching up, the moms were chatting away, the babies were nursing peacefully, all while the administrator called out to remind moms of their upcoming appointments.

Thank you Margo for opening your space and your heart to me and to the world.

I am so grateful for the opportunity to bring you another birth center feature. Without further ado, here is the interview with Margo and my pictures of the facility.

LNBN #1: Are you an accredited birth center?
Margo: Yes, and we are also a member of the AABC, American Association of Birth Centers. 

LNBN #2: How long has your birth center been in practice?
Margo: Three years.

LNBN #3: What is your birth center’s fee and what services does it include?
Margo: The fee is $6,950 and it includes all of a client’s prenatal care, birth care, and postpartum care. We usually start prenatal care at ten weeks. We see clients once a month until the seventh month, then it goes to twice a month, and then at 36 weeks, we do a birth conference which tends to last about an hour. During this birth conference, we talk about birth preferences, newborn care, what they want and what they don’t want after the birth. We show them the rooms again and they pick their first and second choice. We show them where to park and other little details of that sort. After that, we see them every week until they have their baby.

In labor, they come in during active labor—usually between five and six centimeters—and they stay here throughout labor. I would say that the average immediate postpartum stay is about three to four hours, but they can stay up to six hours. They can stay more than six hours, they just have to pay an extra fee for the nurse.

We have registered nurses for all the births. The midwife comes in during labor, and then as the mom gets close to the birth, the registered nurse comes in. After the birth, the midwife will confirm the stability of the mom and then go home. The registered nurse stays until the mom is ready to go home, so the nurse is actually the one who discharges the mom and baby.

Postpartum—one of the registered nurses does a home visit between 24 and 48 hours after the birth to evaluate the mom and the baby. The nurse also does the screening test for the cardiac part and also the newborn metabolic screening, if the mom wants to do that.

Somebody from the birth center calls the mom every day the first week just to check in and make sure everything is going well. Then mom and baby come back to the center for an hour visit at two weeks and six weeks postpartum. The six week appointment is their last one.

There are three classes also included in the fee: a nutrition class (we try to get mom to take this class as early as possible), an early home care class, and a breastfeeding class.

LNBN #4: Do you offer discounts?
Margo: If you come in after 28 weeks, we give a $400 discount. We do this because I don’t want to incentivize people to come in late. I don’t want to encourage people to come at the last minute for a price break because how they get their prenatal care is greatly going to impact their outcome. I want to incentivize people to come in earlier.

LNBN #5: Do you have a sliding scale?
Margo: No.

LNBN #6: Does your birth center participate in insurance plans?
Margo: No, but we are out-of-network.

We have contracted with a third-party biller. There’s two things the client can utilize this biller for. One, if the client pays $25, the third-party biller can check their medical benefits to give them an approximate of what they’d be reimbursed. Two, the client can pay $100 to have the biller do their full billing, and this includes electronically submitting the first bill after the birth and another bill for the baby six weeks later. With option two, the biller would also do all of the follow up and the appeals for the client.

LNBN #7: What community does your birth center service?
Margo: I would say most of our clientele are from Pasadena, South Pasadena, Eagle Rock, Downtown Los Angeles, but we’ve had people come as far as Big Bear.

LNBN #8: Where is the closest hospital?
Margo: Huntington Hospital is 1.4 miles away. The fire department is a block away.

LNBN: Have you every used the fire department?
Margo:  Oh yeah. Their response is pretty immediate.

When the fire department found out that we were building a birth center here, they made all the firefighters go through neonatal resuscitation, which was fantastic!

LNBN #9: What services are offered at your birth center? Do you offer childbirth classes onsite or are there classes you recommend?
Margo: We offer birth. I think birth is our primary focus. We also do well-women care, so we do women’s annual exams and we also do contraceptive care. If someone wants an IUD, they can come and get it here.

We do offer two series of childbirth classes, but they are not our classes. We let the teachers use the space and they teach their classes here. The two that we have now are Two Doulas Birth and Embodica. We’re looking at adding hypno-birthing to the mix because a lot of people are interested in that. We also have a huge referral list that has other childbirth class options.

LNBN #10: Other than English, are there any other languages that the services are provided in?
Margo: Three of the midwives and our medical receptionist know Spanish.

LNBN #11: What type of providers administer care at your birth center?
Margo: We have six midwives—five of them are certified nurse-midwives and one is a licensed midwife—and we have one medical assistant.

LNBN #12: Do you work with student-midwives? If yes, do clients see you, the student-midwife, or both?
Margo: Both. We do have students; however, I only allow one student at a time because I don’t want this to be student-driven. I believe in having students because no one’s teaching this model, and if we don’t teach it to the students, then it will be lost. We want to maintain the model of midwifery care, so that’s why we will have students here, but we are very picky about who we take.

LNBN #13: Can you give me a short back story on your birth center? What inspired it?
Margo: I was doing home births before I opened the birth center. I would always get phone calls for birth centers and the only birth center then was the one in Whittier and the one in Venice.

Delia (our administrative director) and her husband and I are the owners of the birth center. I first met Delia when I was working as a midwife at California Hospital. She was a nurse there. I was her midwife for two children, and we just kept in contact after that. I don’t know how we ever got on the subject, but we decided to open a birth center and we wanted to do it in our neighborhood. It took five years before it happened.

I really wanted to have the option of a birth center because not everybody’s ready for a home birth and not everybody wants a hospital birth. There was no middle ground here, so we created that middle ground.

LNBN #14: What is the birth center’s philosophy of care/mission statement?
Margo: I think it’s that women, if given the chance and guidance, can deliver a baby just fine, and to support that. To me nothing is more important than a birth. I think birth impacts the rest of a person’s life, for the mom and the baby. I think helping people realize this and giving them the best care possible throughout their journey is the best we can do.

I remember delivering my child thinking, “Man, if I could do that, I could do anything!” It left me feeling that way going into parenting. Parenting is tough! The birth is the easy part of this whole process, and going into parenthood with that knowledge about myself was really helpful. It’s really nice to help provide that knowledge to other people.

LNBN #15: Is there anything you’d like to add about your birth center? Is there anything that sets you aside from other birth centers?
Margo: I think our midwives are really special. We have three senior midwives and all of us have worked in hospitals, which I think gives us a whole different appreciation and knowledge. When you see volume, normal and abnormal easily stands out. Not having the volume makes it more difficult to see the abnormal stuff. Only seeing normal makes it challenging to know how to quickly and safely respond to the abnormal.

Our senior midwives not only have the hospital experience, but are also very committed to out-of-hospital. Callie and I had home birth practices, and Sarah developed a birth center in Haiti. Our younger midwives—Jenn, our newest hire, worked at Simona’s birth center for a minute, then came here, and she just got a job at California Hospital. Shayna has only been here and is strongly committed to out-of-hospital. Hayley is our licensed midwife, she has been with me for about five years. Hayley started her apprenticeship program with me when we were doing home births. She then moved into the center with us where she had the benefit of working with three different midwives, which allowed her to see different ways of handling things. Her focus is out-of-hospital.

LNBN #16: What is your favorite area of the birth center and why?
Margo: I like the kitchen. Everybody congregates there. I like sitting in the kitchen because I can see people as they come in and out with the visits. The lobby is also nice because that’s where a lot of the stuff happens.

Thank you Margo!

Now, let me walk you through the birth center Big Nugget style…

 

Thank you so much for visiting with me! I hope you enjoyed and learned something new. If you have any comments, questions, or thoughts, I encourage you to share them with me.

Cheers to Del Mar Birth Center!

Filing a grievance with GAMC

Jasmin Cervantes
[address omitted]

GAMC Customer Service
Attention Kevin Roberts or
Cheif of Staff Michelle Cosgrove or
OB Chair Selena Lantry
1509 Wilson Terrace
Glendale, CA 91206

To whom this may concern:

On September 7, 2016, a multitude of people—mainly women and some men and children—rallied outside of Glendale Adventist Medical Center to stand up against the ban on vaginal breech birth. I was there with the intention of showing my disapproval of the ban in addition to raising awareness of our need for better maternity care in general. I was there rallying for options to exist for pregnant women.

I considered writing a blog post to tell people about the rally I attended against GAMC’s ban on vaginal breech birth, but then I realized I wouldn’t actually be reaching the people that need to read this. I’ve gone ahead and sent a copy of this to all the appropriate people and departments as well as putting it up on my blog.

Please don’t take this as a threat as my intention is not to blame you or call you unethical. No. I am writing this letter to encourage you to be a part of the solution instead of the problem. I am writing to challenge you to be better than the hospitals who do not allow doctors to provide pregnant women with options, better than the insurance companies who force providers to practice unethical care, and better than the academic institutions who decide that teaching how to provide options to pregnant women is not important.

Let me take a step back. I’d like to invite the personnel who is reading this letter—whether it be Kevin Roberts, Michelle Cosgrove, Selena Lantry, or “whom it may concern” in the GAMC Customer Service department—to try and understand that you are one person affecting thousands upon thousands of women, children, and families as a whole. Potentially generations. As an employee of a hospital, you get to clock out at the end of the day, go home, and see your family. There are women who can’t emotionally, mentally, or physically be with their families because they are healing from traumatic experiences that can result from not being informed or not being allowed to make choices. I’ll say it again. You can be a part of the solution by no longer being a part of the problem.

In case you didn’t know, vaginal delivery of a breech baby used to be taught in medical school. Since the Term Breech Trial study in 2001, less and less—rarely any nowadays—doctors are being taught to safely deliver breech babies. Now, I know I don’t have any initials behind my name to give me the credit of knowing this as a fact, but when I hear about bans like the one on vaginal breech birth, it’s obvious that hospitals don’t have the confidence to allow their doctors to attend such births. Sadly, these bans are forcing doctors that are skilled to stop practicing, and they are bullying providers by telling them that they are at risk of being sanctioned. How does this even make sense? How do you feel it is morally alright to stand behind this broken system?

I invite you to stand with us—women, men, and children—because it affects all of us. By keeping this ban in place, you are affecting generations to come. If we remove vaginal breech birth as a viable option for pregnant women, we are allowing ourselves to give into something that is unnatural, unnecessary cesareans. I feel that we need to reserve cesareans for emergencies and for the woman who choose it on their own. Providers and institutions cannot be making these decisions for women. Especially not without asking!

I challenge you to be the example by allowing women to start deciding for themselves. I plead you to stop forcing women into situations that take their power away. You have a skilled provider on staff! Don’t let his knowledge and skills go to waste. Instead of stopping his practice, how are you not celebrating the specialty that Dr. Wu brings to your facility?

This ban is forcing us into an evolution that does not sit well with our humanity. We need your help to preserve the natural abilities of a woman’s body.

Lastly, I’d like to leave you with why I feel passionate enough about this to write to you. Yes, I am standing up to speak for options for all pregnant women. However, my main driving force are my children, especially my daughter. I want to know that I did my part to keep humanity in childbirth. I want to know that my daughter will have options; and although I know it is not possible for every hospital, doctor, insurance company, and/or university to understand how important respectful and humanized childbirth is, I prefer to have had said something than nothing at all.

There is still time to correct the damage that has been done by taking away the option of vaginal breech birth. I have high hopes that you will make the right choice.

Thank you for your time and attention to this very important matter,

Jasmin Cervantes

cc: Kevin Roberts, GAMC Customer Service, Michelle Cosgrove, Chief of Staff, Selena Lantry, OB Chair, Adventist Health Compliance Program

 

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It starts with birth.

 

Maddie’s Playhouse

There’s a little playhouse on the prairie, wait no, that’s not right. Let me try that again. There’s an indoor playhouse in Northridge where the staff is caring, the space is clear, and the sky is limitless…well, as long as you have an imagination. As you walk through the entrance, Junelle—co-owner of the playhouse—greets you will a sincere smile. The playhouse’s atmosphere is warm, friendly, and family-centered. The environment is clean, open, and child-ran—meaning you’ll easily find toys, balls, books, and excited yelling within the building—but also created with parents in mind; there’s wifi, outlets for charging, and a seating area for adults to enjoy. This is Maddie’s Playhouse, the indoor play space I describe. I am blessed to know of this space and am happy to share it with you.

Maddie’s Playhouse is not only an indoor play space for children, but also a family-ran community center where parents can take their children to play while they enjoy adult interaction. If the children are old enough to run around on their own, a parent can take their computer to work on while their child runs around making friends and playing make-believe. That sounds like a win-win right there, don’t you think? I think this sounds better than laying on the couch—getting nothing done—while your kid plays doctor and uses you as his/her patient. (Not a bad idea if your intention is to get nothing done. No judgment here.)

Before I introduce you to Maddie’s Playhouse through my lens, let me clarify that Maddie’s Playhouse is not advertised as a community center. I call it so because…wait for it…drum roll please….I will be teaching childbirth classes here! I am honored and grateful to have this space opened up to me. Now, without further ado, here’s is Maddie’s Playhouse Big Nugget style…


Cheers to dreaming big!